The METER: a brief, self-administered measure of health literacy.

Abstract

BACKGROUND: Given rapidly accumulating evidence that health literacy is correlated with important health-related measures, assessing patients' health literacy level is of increasing concern for researchers and practitioners. Practical limitations for use of existing health literacy measures include length of time and practitioner involvement in administration. OBJECTIVE: To develop and validate a brief, self-administered measure of health literacy, the Medical Term Recognition Test (METER). PARTICIPANTS: 155 participants were recruited from an outpatient cardiology program at an urban hospital. MEASURES: Patients completed measures of health literacy (METER and REALM), neuropsychological function, psychosocial health, and self-report questionnaires about health behaviors. Indicators of cardiovascular health were also recorded from patients' medical charts. KEY RESULTS: The measure took 2 min to complete. The internal consistency of the METER was 0.93, and it correlated highly with REALM (r = 0.74). Regarding sensitivity and specificity for identifying individuals below REALM's cutoff for functional literacy, METER resulted in 75% correct identifications and 8% false positives. METER and REALM were both associated with various health-related measures (including significant correlations with measures of neuropsychological function and cardiovascular health). CONCLUSIONS: These initial findings show that the METER is a quick and practical measure of health literacy for use in clinical settings.